Health inequalities
The general level of health and wellbeing of Finns has improved continuously, but the distribution of health and wellbeing among the population is becoming increasingly unequal. Inequality occurs between socio-economic groups in almost all areas of health and welfare.
What is the socio-economic status?
The socio-economic status consists of both the material resources of wellbeing and the prerequisites needed for obtaining them. These material resources are income, property and the level of housing and the prerequisites for obtaining them are education, occupation and position in the world of work.
Education modifies a person’s knowledge, skills and values and affects his or her occupational position. The occupation and the place of residence affect working conditions, govern behaviour and affect livelihood. The financial situation in turn governs the consumption opportunities and the housing conditions.
Socio-economic status contributes to health inequalities
The socio-economic status affects a person’s health in many ways. Matters affecting health include
- exposure to factors that are detrimental to health or promote health
- traditions, values, attitudes and social networks related to the socio-economic position
- use of social welfare and healthcare services and the benefits gained from them
Health also affects the person’s social position. Those in good health do better in education and in the job markets, while people struggling with health problems are at a greater risk of ending up in a poor social position.
The problem is exacerbated by the fact that the healthcare system does not always treat people equally. For decades one of the main goals of the Finnish health policy has been to offer all residents access to timely and high-quality health care according to need, irrespective of socioeconomic position, economic resources or region of residence. However, researchers have reported differences in both access to and quality of care.
Health inequalities can be reduced by dismantling inequality
Health and welfare inequalities can be reduced by influencing the underlying social factors and inequality.
- Social inequality is reduced, for example, through education, income distribution, employment opportunities and taxation.
- Healthy living conditions are secured for everyone (housing, working conditions, environment).
- Exposure to harmful substances is reduced (exposure factors at work and in the environment, alcohol, tobacco, unhealthy nutrition).
- Vulnerability is reduced (social networks, special support to people in a vulnerable position).
- Unequal consequences are prevented (for example, by ensuring equal availability and quality of services).
Differences in mortality in Finland
There are clear differences in mortality between the socio-economic groups. People who have a higher education degree, work in senior positions or have a high income live on average longer than people who have completed basic education, work in lower-level jobs and have a low income.
The remaining life expectancy of a 25-year-old woman who belongs to the highest-earning 40 per cent is approximately 61 years, while in the lowest quintile it is almost five years less. The corresponding difference is 9 years for men. From an international perspective, the differences in Finland are wide.
Cardiovascular diseases, alcohol and tobacco behind differences in mortality
Cardiovascular diseases and alcohol-related deaths are the most important factors explaining the differences in mortality. Among men, slightly under one third of the differences in mortality between the income groups are caused by alcohol and among women, slightly under one fifth. Among people with the lowest income, the number of years of life lost because of alcohol-related reasons is almost eightfold compared to people with the highest income. In deaths related to cardiovascular diseases, the corresponding figure is 3.6 and in cancer deaths, 1.7.
Smoking also increases the risk of illness and untimely death. In the past few decades, smoking as a whole has decreased among both those with a low and those with a high level of education. However, the differences between the educational groups have increased.
It is possible to reduce smoking, alcohol use and the resulting health inequalities through legislation, pricing and tax policy, and especially by supporting the risk groups in adopting a healthy lifestyle.
